From Villainous Letch and Sinful Outcast, to “Especially Beloved of God”

Complicating the Medieval Leper through Gender and Social Status

in Historical Reflections/Réflexions Historiques

Abstract

This article explores the socio-religious construction of the medieval “ideal” leper; a male pedagogical symbol of social and moral status and a figure in a physical and spiritual state of liminality, where their physical decay was a sign of their moral corruption. It argues that within vernacular literature, and theology, the medieval male leper was typically perceived as an outcast experiencing social death before succumbing to the slow degeneration of the disease. Typically conceived, and represented as lusty and carnal, the “ideal” male leper wore his own sin as physical deformity as a result of the close theological interpretation of the body and the soul. However, once his spiritual and physical contagion was contained within a leprosaria (a leper hospital), he could be perceived as a semi-holy figure, living out his purgatorial punishment on earth. Living out his purgation and segregated from his former communities, the article contests that the once frightening and sinful medieval male leper could transform his social status, becoming “especially beloved by God.”

In Leprosy in Medieval England, Carole Rawcliffe argued that leprosy was a disease that “played a notable part in the medieval imagination and was accorded significance far beyond the physical threat it actually posed to the population.”1 The unique hazard that leprosy represented can be seen through two unprecedented royal edicts, issued in 1346 and 1472, which were designed to remove lepers, initially from within the walls of London, but later from all major towns and cities.2 The punishment for non-compliance with this edict, and for the crime of insidiously spreading the disease among the community, was that lepers were to be whipped as vagrant rogues, although there was also the threat of execution.

A literally rotten disease, there was no real cure for leprosy and no proper understanding of how this slow contagion spread. Furthermore, there was no real diagnosis and almost any skin condition could fall under the leprous label. Perhaps most significantly, during this period of history when there was no distinction between the social and the religious, lepers were a threat to both society and morality. Leprosy then can be understood as being more than a medical condition that affected real individuals. It was a socio-religious construct, and there was in the medieval mind-set a notion of the “ideal” leper: “ideal” in the Weberian sense of a non-real, utopian “accentuation of one of more points of view.”3 This “ideal” leper was a pedagogical symbol that represented both a social and moral status and was a figure in a physical and spiritual state of liminality, where bodily decay was a sign of moral corruption; and this “ideal” leper was male.

The notion that men were more prone to leprosy than women dates to the fifth-century Byzantine physician Aetius;4 a finding reinforced in modern society by recent World Health Organization statistics which note that “although leprosy affects both sexes, in most parts of the world males are affected more frequently than females often in the ratio of 2:1.”5 Although women did contract leprosy in the medieval period, archaeological evidence suggests that it was a disease overwhelmingly associated with men. In the cemeteries of the leper hospitals of St. James and St. Mary Magdalene in Chichester, over 72 percent of all the leprous burials were male, and in Winchester and Buckingham on the whole the number of male skeletons outweigh those of females.6

We have chosen to explore the construct of the medieval ideal male leper by examining vernacular literature and medieval theology. We argue that, although the medieval leper was typically perceived of as an outcast experiencing a social death before succumbing to the slow degeneration of the disease, once explored specifically through the lens of gender and status, this image can be complicated, for in specific situations the leper was one of God’s elect, destined for an afterlife that only the sainted enjoyed.

The Scientific Diagnosis of Leprosy and Its Social Effects

Ian Mortimer notes that in the Middle Ages, leprosy was the “most terrifying illness which people could imagine.”7 The most prolific and mutilating form known to contemporary medicine, lepromatous leprosy, is thought to have been a common medieval strain of the disease. Clinically this disease can take up to twenty years to fully manifest, initially presenting itself as nasal congestion, swelling of the limbs, and nerve damage. Eventually lesions manifest before ulceration of skin and eyeballs occurs; nodules emerge and the extremities would become paralyzed and eventually rot away. Mortimer claims that lepers would have suffered from alopecia, bodily bleeding, putrefaction of the nose and penis, as well as loss of teeth; considering these symptoms, one must concur with his view that “ultimately lepers were wholly deformed, stinking, repulsive and blind … [and] that is why it was called the ‘living death’.”8

The description of the Summoner’s affliction in Chaucer’s Canterbury Tales provides a useful view of perceptions of the contagion. Typically a lower-class church official who “brought people before the ecclesiastical court for acts such as illicit intercourse,”9 as Walter Curry notes, “Chaucer’s Summoner is dangerously ill, suffering from a species of morphea known as gutta rosacea, which has already been allowed to develop into that kind of leprosy called alopecia, according to the medieval understanding of his symptoms.”10 This could be indicated by the Summoner’s “fire-red face … the details about the eyebrows, his narrow eyes, and the white ‘whelkes’ and ‘knobbes’ on his cheeks,”11 although whether he in fact had scabies is a moot point, for medieval medical doctors grouped skin conditions together. In the Science of Surgery by the thirteenth-century doctor Lanfrank, it is noted that “lepers will have other common signs,” meaning that if someone had leprosy they also had scabies.12

Many scholars, such as Michael Foucault,13 Saul Brody,14 and Bryan Turner,15 consider that by the end of the twelfth century, the subject of leprosy was so prolific in vernacular literature that one could easily construct an image of a veritable leprous epidemic. Though leprosy was by no means a “new” disease, such as the plagues that were to follow in the fourteenth century, the demographic of those infected with leprosy suddenly altered during the twelfth century. From 1100 to 1175, leprosy infected “large quantities among the dispossessed, leaving its former victims [the elite, wealthy, nobles and bishops] alone,”16 and with this social change in the spread of the disease, aspects of social control also altered. With, as Johan Goudsblom notes, “the rich and powerful seem[ingly] … practically immune” to the condition,17 and with the alteration to socio-economic conditions resulting in masses of landless poor and destitute individuals, there was a certain practicality in labeling vagabonds, beggars, and even heretics as lepers. Jeremy Seabrook elucidates that as the “threat” from religious justifications for disturbances to the social order receded, “‘the poor’ [were seen] as a secular menace to society [who] accompanied the dissolution of Feudalism. Migratory, un-attached, begging, the mass of poor were enfranchised from Feudalism.”18 This in turn provoked resentment within society, representing the decay of order.19 The decline of feudalism was accompanied by new interpretations of Christian doctrine, particularly texts such as the Festial of the English Augustinian Canon Regular, John Mirk, which insisted on compassion for the poor, the oppressed, and the sick.20

As accusations of leprosy rose, so did the need for segregation, for while leprous individuals were a physical threat to society, they also represented society’s depravity, and both needed containing. Further, both the body and soul needed treating, and this was achieved through the construction of leprosaria: a form of hospital, built outside of city perimeters and incorporating a cemetery and often a chapel with a priest, which accommodated the physical and spiritual care of the leprous patient. Large towns and cities typically had numerous leprosaria, and overall, there were approximately three hundred constructed in England before the early fourteenth century, demonstrating the rising rates of supposed infection during this time period.21 It should be noted, however, that although these hospitals were integrated into the social fabric of medieval society, they contained fewer lepers than one might imagine.

Sexuality and Leprosy: A Medieval Calculus

The typical medieval male leper was understood as lusty and carnal; the edit of 1346 in England stated that infection was by “way of mutual communication … as by carnal intercourse with women in stews.”22 This notion was represented in vernacular culture in characters such as the sex-crazed lepers in Shakespeare’s Troilus and Cressida23 and the lepers in the medieval romance Tristan and Isolde, who suggest that the adulterous Isolde be handed over to them to be raped to death.24

For women, too, it should be noted that there was a strong association between leprosy and sex. Aetius had suggested leprosy was contractable via sexual contact,25 as did the Abbess Hildegard of Bingen (1099–1179), who believed it was firmly associated with lustful sex;26 a suggestion posited by the first century Greek physician Aretaios.27 Meanwhile, some medieval commentators asserted the condition was contracted through having sex with menstruating women;28 thus a further link between leprosy and improper sexual conduct.

Lepers’ exaggerated physical deformity, and the physical pain that accompanied it until their eventual deaths, did not promote sympathy to the medieval onlooker. Rather, the fact that the disease progressed slowly and could be concealed during the early and most infectious stages provoked accusation within the community, with the accusations necessitating a target suspect. The manifestation of the disease itself provided some indication as to why victims were infected; in particular, the decomposition of the nose demonstrated a direct link to leprous contagion and sexual misbehavior. In medieval society loss of the nose “was widely regarded as a sign of infamy, since it served to brand criminals and sexual miscreants.”29 Such an obvious deformity could not be hidden and unequivocally highlighted that the disease had entered its final phase. In the medieval mindset, as Sander Gilman has argued, the nose was an integral part of one’s face and one’s identity,30 and indeed to be noseless left one “a non-person, no longer a full part of … society.”31 Effectively socially dead, the lack of a nose was symbolic of a low social status. As justified by the book of Leviticus (21: 18), “the denasti, or noseless, were deemed ineligible for the priesthood because of their blemish, and presented … a striking example of the connection between physical disfigurement and moral turpitude.”32

The link between the noseless and those of low moral status can be seen throughout history. In medieval Venice female offenders had their noses cut off not only as punishment for a specific crime, but also as a future warning to others of their inherent unsociable behavior.33 However, as early as Ancient Egyptian times, we find the association of denasti with sexual misconduct, where cutting off the nose was a punishment for adultery.34 The Ecloga, the Byzantine legal code published in 726, continues this theme with laws 23 and 24 stating that carnal knowledge of a nun or virgin woman would result in a man having his nose slit.35 Destruction of the nose was indicative of the destruction of one’s honor, and specifically symbolized the incompleteness of one’s body. Nowhere was this more clear than in the desperate acts of self-mutilation by nuns to stop invading forces raping them; both the nuns of St. Cyr Monastery, Marseilles, under their abbess Eusebia, and those of Coldingham Priory in Scotland with their abbess Ebbe, carried out this extreme act to stop the Saracens and Vikings, respectively, from taking their virtue.36 Elizabeth of Hungary similarly threatens such action when urged to remarry by her uncle after the death of her first husband.37

While, in the case of women, the loss of the nose is equated with the loss of sexual desirability, the loss of a nose for men had a different connotation.38 As Aretaios noted, noselessness was equated with enhanced or immoral sexual desire; Frederick II (1194–1250) used this rationale in his punishment of those guilty of adultery, and males guilty of having favored prostitution, which involved the forced removal of the nose.39

Nearly all medieval depictions of lepers in literature are male. We have mentioned references to lepers in Troilus and Cressida, Tristan and Isolde, and Chaucer’s Summoner, but visual depictions of lepers in manuscripts and bibles also tended to be male, as an internet image search using the term “medieval leper” can demonstrate.40 Males then were the main targets of suspicion, and men were considered virulent and sexually dangerous. Robert Moore describes the male medieval lepers as being “endowed with an inordinate sexual appetites … incestuous … rapists … [who] sought to spread their condition by forced sexual intercourse with healthy persons.”41 Therefore, leprosy and lechery become interchangeable terms, as emphasized by Richard Rolle of Hampole’s fourteenth-century The Pricke of Conscience stating: “And som, for 3e syn of lechery, / Sal haf als 3e yvel of meselry.”42 Further, the prominent mystic Margery Kempe also prayed for her son to be punished by God for his dissolute lifestyle and that his “synne of letchery [was] sone aftyr [punished], his face wex ful of whelys and bloberys as it has ben a lepyr.”43 And returning to the Summoner, Chaucer describes him “as hot … and lecherous” with a demeanor that frightened children.44 Even the royal edicts mentioned earlier emphasized that lepers were perceived to be lecherous males of low social status, notably frequenters of brothels.

The threat of the lecherous leper was contained within their desire and potential to infect victims via carnal intercourse, insidiously contaminating the healthy. Susan Sontag notes that “leprosy in its heyday aroused a … disproportionate sense of horror [being] one of the most meaning-laden diseases, with victims being subject to outside projections of immorality, where feelings of evil are projected onto a disease and becoming increasingly meaning-laden, a hyperbole of the disease is projected back onto society.”45 As such, medieval leprosy became a socially constructed metaphor of moral and literal contagion, a symbol of the disgust associated with decay, pollution, anomie, weakness, and ugliness.46 The leper becomes a social text, corruption made visible through a male emblem of decay,47 enforcing the church teaching that sin was often the cause of bodily disease. Banished from the community the leper was a social outcast and considered loathsome; they were according to the Abbot of St. Julian’s hospital in St Alban’s, “to bear themselves as more to be despised and as more humble than all other men.”48 However, being humble was not necessarily a bad thing, for Jesus sided with the humble, and thus we move into exploring how the despised leper could, in certain circumstances, shift their social status. This rests on the notion of liminality and medieval theology, for while the leper was in everyday society an abhorrent outcast, a socially dead unwanted wanderer wearing his depravity, once contained within the liminal space of the leper hospital, his socially dead status and living dead appearance could be utilized by the church for religious purposes. It is at this stage that we need to elucidate medieval concepts of death and the afterlife.

The “Ideal” Leper and the Notion of Redemption

The “ideal” leper was a man who, due to theological interpretations of the body as essentially the mirror of the soul, wore his own moral sin as a physical deformity. This notion was perhaps most clearly expressed in Chaucer, where the Summoner in the Canterbury Tales is described as quintessentially a “good felawe,”49 that is, one who inhabits the taverns and brothels, and a companion of pimps and prostitutes. This quite open debauchee50 is not only sexually immoral but his overtly licentious behavior is a vivid symptom of deeper corruption: his clerical sin in obtaining financial gain through the abuse of his ecclesiastical power. This sinful behavior correlates with his leprosy. The representation of wearing one’s inner sin outwardly is also found in the romantic tale of Amis and Amiloun where Amiloun contracts leprosy for deliberately disobeying God:51 the character becomes “as foul a leper as ever was born in this world!”52 Frightening and repulsive in everyday society for the contagious nature of his bodily and moral corruption, Amiloun wandered for several years as a beggar, but if he had been contained within a leprosaria, his spiritual and physical contagion could be perceived as semi-holy with the man living out his purgatorial punishment on earth.

Although Catholicism at the time acknowledged four afterlife destinations—heaven, hell, purgatory, and limbo—most people went to purgatory. Formulated in the Second Council of Lyons (1274), “purgatory … [was] a halfway stage between earth and heaven, where the sinful but repentant … could, through purgatorial cleansing punishment, complete the process of making satisfaction for sin and so be rendered fit for heaven.”53 As expressed in Dante’s Comedy, purgatorial punishment fitted one’s earthly venial sins, so for example the greedy who enjoyed their material possessions shamelessly were bound and forced to lay on their stomachs and recite Psalm 119:25: adhaesit pavimento anima mea (my soul is attached onto dust), while the arrogant, being too erect in life, were made to carry rocks on their backs keeping their faces to the ground. One could lessen one’s postmortem punishments through certain acts conducted in one’s lifetimes, such as pilgrimage, praying for the dead, and purchasing indulgences. Further, in the wake of St Francis’s (ca. 1181–1226) dramatic change in attitude toward lepers, shifting from repellence to active acceptance of, and servitude to, them, caring for lepers became another way of adding to one’s Treasury of Merit: a Biblical inspired source of indulgence based on one doing good works that benefit others (Mt 6:19–20).

The role of the church in perceptions of leprosy is important here and helps explain the shift of lepers as social outcasts to effectively the elect of God. The Bible had always had an ambiguous relationship to leprosy, with the Torah/Old Testament seeing Aaron and Miriam temporarily punished with leprosy for the sin of speaking against Moses (Num 12:10–14), and the skin condition associated with uncleanliness and segregation (Lev 13:46, Num 5:2–4, 2 Kings 15:5, 2 Chron 26:16–21) as well as with the living dead, bodies half eaten away (Num 12:10–12, Job 18:13). However, in the New Testament, Jesus heals lepers (2 Kings 5:1–15, Mk 1:40–45, Lk 17:11–19) and his ability to heal leprosy is seen as a sign of his messiah-hood (Mt 11:5, Lk 7:22). Further, lepers were understood to have an elect status postmortem, which was evident in the Christian parable of the rich man and Lazarus the beggar (Lk 16:19–31). The Third Lateran Council (1179) noted that any disfiguring skin ailment was deemed leprous, and that lepers were “living dead … barred from inheritance, denied the right to make gifts, unable to plead in court or negotiate contract.”54 Canon 23 then castigated lepers socially, even requiring them to wear identifying insignia, but although social outcasts they were given a status. The theological status of a leper dates to an edict from the Council of Lyon (583), which expressly forbade lepers to associate with the healthy. While this effectively placed them in the realms of the socially dead, it did mean that lepers needed to have their own churches and or cemeteries, with the benefit of a priest. Lepers might be marginalized and socially outcast from normative society, but the 583 edict ensured they were cared for spiritually, and the 1179 edict furthered this by requiring towns and cities with leper hospitals to house and feed lepers in their boundaries. Unable to work or care for themselves, these hospitals or leprosaria, provided shelter, food, and physical and spiritual care through the donations of alms, with the donors effectively buying some lessening of their purgatorial punishments through their charitable acts.

With a Christian theological imperative of acts of kindness toward to lepers, perhaps best exemplified through the Franciscan model of care for the leprous, together with perceived connections between the suffering Christ and the suffering leper,55 it is perhaps unsurprising that from the twelfth to the fourteenth century we should find a number of saints engaging directly with lepers. Saint Thomas Beckett (d. 1170), Saint Hugh of Lincoln (d. 1200), Saint Elizabeth of Hungary (d. 1231), Saint Hedwig of Silisia (d. 1243), Saint Louis of France (d. 1270), and Saint Elzear of Sabran (d. 1323) are all notable for their pro-leper stances, licking lepers’ sores, kissing leprous lips or feet, or noting the preferable status of living as a leper to dying of mortal sins.56 Canon 22 of the Fourth Lateran Council (1215) correlates sickness of the body and the result of sin;57 we thus find a number of contemporary sermons utilizing leprosy metaphorically to encourage proper Christian praxis. Jacques de Vitry (c. 1160–1240) discussed lepers as the elect of God in both his first and second sermon ad lepros: lepers will be certain of their celestial rewards, having endured suffering on earth rather than in purgatory, provided they devote their life to their spiritual health. Humbert of Romans (c. 1190–1277), in his composition of sermons for preachers, suggests those who visit lepers should be regarded as pious. He also noted that lepers should confess their sins and spend their days focusing on their afterlife, accepting with patience their current situation, “comforted by the example of Job.”58 Guilbert de Tournai (c. 1200–1284), another sermon writer, even went so far as to note that, as long as lepers resisted earthly temptations, after their death they would be nursed by Christ; the leprosaria was clearly the place they should be.59

The Leprosaria as Earthly Purgatory

The physically alive, but socially dead leprous individuals were forced to accept a new residence in the leprosaria.60 Lepers were then liminal beings, bodies in transition, with individuals separated from their former lives but not yet integrated into a future state of being, residing in a liminal state of earthly purgatory before entering a final afterlife destination. The purgatorial status of the leper was further emphasized by their visibly fragmenting and rotting bodies. Caroline Walker Bynum posits that “because parts broke off the leper’s body, because it fragmented and putrefied and became insensate when alive, in other words because it was a living death … it was used as a common metaphor for sin.”61 “Continuity of matter was necessary for continuity of the person,”62 and bodily fragments were perceived to contain remnants of spiritus, which in turn contained inherent contagion. Thus, the decaying body of a leper represented the decaying social fabric and the manner in which sin could quite literally rot the soul. The medieval leprous body was a metaphor of social disorder, born of lechery, specifically related to the male, and disintegrating: it needed removal. The physical body was the body politic and the religious body, all in one.

Rawcliffe asserts that “the spots and stains of leprosy … served as an effective metaphor for various manifestations of sin.”63 The assumption that spiritual deformity would somehow leave its trace upon the body as well as soul insidiously found its way into religious and secular literature alike. Not only physical, but also spiritual leprosy became threatening, as an anonymous fourteenth-century sermon states. For just as leprosy makes the body ugly and loathsome and repulsive, so the filth of lechery makes the soul spiritually very foul.64 However, by entering purgatory prematurely, lepers had an unprecedented opportunity to pay off their purgatorial debt in this life rather than the next. As Bernard de Clairvaux (d. 1175) claimed, chronic disease was “a divine gift, pregnant with opportunity.”65 Anselm, too, proposed that “the progress of the soul grows out of the failure of the flesh, the salvation of the soul out of the illness of the flesh and forgiveness out of punishment.”66 Leprosy allowed the isolated victim to repent and atone for their sins, acting as a “spur to salvation.”67 Thus, “the leper had been granted the special grace of entering upon payment for his sins in this life, and could therefore look forward to earlier redemption in the next.”68 The leper in this sense was like the biblical figure of Job: he was especially beloved of God, and would win his reward in heaven for his sufferings on earth.69 Considering the horrors that awaited in purgatorial afterlife, purgation before death seems to identify lepers as privileged, marked out by divine favor to suffer in this life, to lessen their suffering in the next.70 However, lepers still occupied an unstable position within everyday society: lepers were socially undesirable, yet social examples, maintaining humility while experiencing a holy disease that would relieve their suffering in the afterlife.

To conclude, we have argued that medieval leprosy was a slowly progressive disease that contemporarily—in vernacular literature and theology—had close links to lechery and male sexuality. The obvious fragmentation of the body enabled accusation and ostracization, with formal diagnosis and moral censure of lepers being provided by the church. The loss of the nose in particular indicated the close relationship between sexual miscreancy and leprosy; however, royal edicts also associated this misbehavior with vagrants, vagabonds, and more generally the lower classes. Thus, a distinct image of the ideal leper is constructed: the nobility did not possess the qualities that pre-disposed them to leprosy, whereas the lewd, male, destitute poor were more liable to become infected. Leprosy was therefore intrinsically linked to gender and social status in medieval society. Lepers as liminal beings, betwixt and between states, required separation and segregation from their former communities. Their dissolving flesh being representative of postmortem decay, in turn indicated the leper’s status as a purgatorial sufferer who needed to be contained and isolated within the walls of the leprosaria. With leprosy, the physical manifestation of the sins of the soul pedagogically informed those who witnessed the physical signs and symptoms of the disease: that immoral behavior will be punished either in this life, or more severely in purgatory. Therefore, as Bernard of Clairvaux, and Anselm proposed, leprosy as a physical disease of the soul was pregnant with opportunity. Lepers, as spiritual sufferers, could achieve early release from the torment of purgatory. But, as Rawcliffe posits, “embodying in his or her person a stark reminder of the ordeal to come, the leper cut a profoundly disturbing figure,”71 and thus we suggest, the “ideal” male leper could be especially beloved by God, both holy and horrific.

Notes
1

Carole Rawcliffe, Leprosy in Medieval England (Woodbridge: Boydell Press, 2006), 17.

2

Rawcliffe, Leprosy, 275.

3

Max Weber, The Methodology of the Social Sciences (Glencoe, IL: Free Press, 1924; reprinted 1949), 90.

4

Pierre J. G. Cabanis, An Essay on the Certainty of Medicine, trans. R. La Roche (Philadelphia: Robert Desilver, 1828), 104.

5

World Health Organization, “Transmission of Leprosy,” accessed 24 August 2015, http://www.who.int/lep/transmission/en/

6

F. Lee and J. Magilton, “The Cemetery of the Hospital of St James and St Mary Magdalene Chichester—A Case Study,” World Archaeology 21, no. 2 (1989): 278–279; Simon Roffey and Phil Marter, “St Mary Magdalene Hospital, Winchester,” Archaeology, 17 (2011), accessed 24 August 2015, http://www.archaeologyuk.org/ba/ba117/feat2.shtml; Michael Farley and Keith Manchester, “The Cemetery of the Leper Hospital of St Margaret, High Wycombe, Buckinghamshire,” Medieval Archaeology 33 (1989): 82–89.

7

Ian Mortimer, The Time Traveller’s Guide to Medieval England: A Handbook for Visitors to the Fourteenth Century (New York: Vintage Books, 2009), 204.

8

Ibid., 204.

9

Michael Delahoyde, “The Summoner’s Tale,” accessed 24 August 2015, http://public.wsu.edu/~delahoyd/chaucer/SumT.html

10

Walter C. Curry, Chaucer and the Medieval Sciences (New York: Barnes and Noble, 1960), 395.

11

Caroline D. Eckhardt, Chaucer’s General Prologue to the Canterbury Tales: An Annotated Bibliography, 1900 to 1982 (Toronto: University of Toronto Press, 1990), 398.

12

Bryon Lee Grigsby, Pestilence in Medieval and Early Modern English Literature (London: Routledge, 2004), 84.

13

Michael Foucault, The Archaeology of Knowledge (London: Tavistock Publications, 1972), 16.

14

Saul Nathaniel Brody, Disease of the Soul: Leprosy in Mediaeval Literature (Ithaca: Cornell University Press, 1974), 103.

15

Bryan S. Turner, The Body and Society: Explorations in Social Theory (Oxford: Blackwell, 1984), 66–151.

16

Mary Douglas, “Witchcraft and Leprosy: Two Strategies of Exclusion,” Man, New Series 26, no. 2 (1991): 732.

17

Johan Goudsblom, “Public Health and the Civilising Process,” Millbank Quarterly 64, no. 2 (1986): 166.

18

Jeremy Seabrook, Pauperland: Poverty and the Poor in Britain (New York: Hurst Publishers, 2013), 21.

19

Ibid., 26.

20

Judy Ann Ford, John Mirk’s Festial: Orthodoxy, Lollardy and the Common People in Fourteenth-Century England (Cambridge, D.S. Brewer, 2006): 71.

21

Ibid., 190.

22

Ibid., 275.

23

David Marcombe, Leper Knights: The Order of St. Lazarus of Jerusalem in England, C.1150–1544 (Woodbridge: Boydell Press, 2004), 140

24

Jeffrey Richards, Sex, Dissidence and Damnation (London: Routledge, 1994), 160.

25

Samuel Lane, “A Course of Lectures on Syphilis: Lecture II,” The Lancet MDCCCXLI–XLII, in Two Volumes, Volume the First, ed. Thomas Wakley, (London: George Churchill, 1841–1842): 281–286.

26

Franjo Gruber, Jasna Lipozenčić, and Tatjana Kehler, “History of Venereal Disease from Antiquity to Renaissance,” Acta Dermatovenerol Croat 23, no.1 (2015): 1–11.

27

Timothy S. Miller and John W. Nesbitt, Walking Corpses: Leprosy in Byzantium and the Medieval West (Ithaca: Cornell University Press, 2014), 157.

28

Richards, Sex, Dissidence and Damnation, 160.

29

Rawcliffe, Leprosy, 140.

30

Sander Gilman, Making the Body Beautiful: A Cultural History of Aesthetic Surgery (Princeton, NJ: Princeton University Press, 1999), xx.

31

Patricia Skinner, “The Gendered Nose and Its Lack: ‘Medieval’ Nose-Cutting and Its Modern Manifestations,” Journal of Women’s History 26, no. 1 (2014): 50.

32

Valentin Groebner, “Losing Face, Saving Face: Noses and Honour in the Late Medieval Town,” History Workshop Journal 60 (1995): 1–15.

33

Nella Lonza, “On Cutting off Noses and Pulling out Beards: Face as a Medium of Crime and Punishment in Medieval Dubrovnik,” in Our Daily Crime, ed. Gordon Ravančić (Zagreb: Hrvatski Institut za Povijest, 2014), 61.

34

G. Sperati, “Amputation of the Nose Throughout History,” Acta Otorhinolaryngol Italy 29, no. 1 (2009): 44–50.

35

Martha A. Brozyna, ed., Gender and Sexuality in the Middle Ages: A Medieval Source Documents Reader (Jefferson: McFarland and Co., 2005), 110.

36

For nuns of St Cyr, see Liz Wilson, Charming Cadavers: Horrific Figurations of the Feminine in Indian Buddhist Hagiographic Literature (Chicago: University of Chicago Press, 1996), 172; for nuns of Coldingham, see Rev. J. B. Mackinlay, St. Edmund, King and Martyr (New York: London and Leamington Art and Book Company, 1893), 109.

37

See Larissa Traacy, Women of the Gilte Legende: A Selection of Middle English Saints’ Lives (Cambridge: D.S. Brewer, 2003), 63.

38

Corinne J. Saunders, Rape and Ravishment in the Literature of Medieval England (Cambridge: D.S. Brewer, 2001), 141, 145.

39

Giorgio Sperati, “Amputation of the Nose throughout History,” Acta Otorhinolaryngol Ital 29, no. 1 (2009): 44–50, accessed 24 August 2015, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689568/.

41

Robert Ian Moore, The Formation of a Persecuting Society (Oxford: Oxford University Press, 1987), 54–55.

42

Richard Rolle of Hampole, The Pricke of Conscience: Stimulus Conscientiae: A Northumbrian Poem, ed. Richard Morris (London: A. Asher, 1863), 82.

43

Margery Kempe, The Book of Margery Kempe: Vol. 1, ed. Sanford Brown Meech (London: Oxford University Press, 1940), 221–223.

44

Chaucer cited in Moore, Formation of a Persecuting Society, 54–55.

45

Susan Sontag cited in Marcia Gaudet, “Telling It Slant: Personal Narrative, Tall Tales, and the Reality of Leprosy,” Western Folklore 49, no.2 (1990): 193.

46

Goudsblom, “Public Health,” 194.

47

Ibid.

48

John Stuart, “Archaeological Essays by the late Sir James T. Simpson, Baet, Vol. II,” accessed 1 September 2014, http://archive.org/stream/archaeologicales02simpuoft/archaeologicales02simpuoft_djvu.txt, 136 and William Page, “Hospital of St. Julian by St Albans,” in A History of the County of Hertfordshore, Vol. IV, ed. William Page, accessed 1 September 2014, http://www.british-history.ac.uk/report.aspx?compid=37985, 464–467.

49

Geoffrey Chaucer, “The Summoner,” The Canterbury Tales, accessed 24 August 2015, http://www.librarius.com/canttran/genpro/genpro625–670.htm.

50

Richard Firth Green, “The Sexual Normality of Chaucer’s Pardoner,” accessed 24 August 2015, http://sites.fas.harvard.edu/~chaucer/canttales/pardt/pard-gre.htm.

51

See lines 1250–1270 in Ken Eckert, “Chaucer’s Reading List: Sir Thopas, Auchinleck, and Middle English Romances in Translation,” (PhD diss., University of Nevada, 2011), accessed 1 September 2014, http://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=2037&context=thesesdissertations, 50.

52

Amis and Amiloun, trans. Edith Ricket (Cambridge: Middle English Series, 2000), 17

53

Rosemary Horrox, “Purgatory, Prayer and Plague: 1150–1380,” in Death in England: An Illustrated History, ed. Peter Jupp and Clare Gittings (Manchester: Manchester University Press, 2000), 90.

54

Elaine Clark, “Social Welfare and Mutual Aid in the Medieval Countryside,” Journal of British Studies 33, no.4 (1994): 396.

55

Holkham Bible, Add MS 47683, accessed 24 August 2015, http://www.bl.uk/manuscripts/FullDisplay.aspx?ref=Add_MS_47682; Carol Rawcliffe, “The Lost Hospitals of London: Leprosaria” (lecture delivered at Gresham College, London, 3 May 2012), accessed 24 August 2015, http://www.gresham.ac.uk/lectures-and-events/the-lost-hospitals-of-london-leprosaria.

56

Kay Brainerd Slocumb, Litergies in Honour of Thomas Becket (Toronto: University of Toronto Press, 2004), 89; Decima L. Douie and D. Hugh Farmer, eds. Magna Vitae Sancti Hugonis: The Life of St. Hugh of Lincoln (Oxford: Clarendon Press, 1985), 2:84; Kenneth Baxter World, The Life and Afterlife of St. Elizabeth of Hungary (Oxford: Oxford University Press, 2010), 69; Gábor Klaniczay, Holy Rulers and Blessed Princesses: Dynastic Cults in Medieval Central Europe (Cambridge: Cambridge University Press, 2002), 203; Joseph Vann, “Saint Louis—Confessor, King Of France—1214–1270 Feast: August 25,” accessed 1 September 2014, http://www.ewtn.com/library/mary/louis.htm; and Christine M. Boeckl, Images of Leprosy: Disease, Religion and Politics in European Art (Kirksville, MO: Truman State University Press, 2011), 88.

57

Irina Metzler, Disability in Medieval Europe: Thinking about Physical Impairment during the High Middle Ages, c. 1100–1400 (London: Routledge, 2006), 47.

58

Humbert of Romans cited in Courtney A. Krolikoski, “Malady or Miracle? The Influence of St Frances on the Perception of Leprosy in the High Middle Ages” (MA thesis, Central European University, 2011), 140.

59

Ibid.

60

Clark, “Social Welfare,” 40.

61

Caroline Walker Bynum, Fragmentation and Redemption (New York: Zone Books, 1992), 276.

62

Caroline Walker Bynum, “Material Continuity, Personal Survival, and the Resurrection of the Body: A Scholastic Discussion in Its Medieval and Modern Contexts,” History of Religions 30, no. 1 (1990): 81.

63

Rawcliffe, Leprosy, 48.

64

Anon in John Small, ed., English Metrical Homilees (Edinburgh, 1862), 129–130.

65

De Clairvaux cited in Rawcliffe, Leprosy, 56.

66

Anselm of Canterbury, The Letters of St. Anselm of Canterbury, Vol. 1. (Ann Arbor: University of Michigan Press, 1990), 163.

67

Rawcliffe, Leprosy, 53.

68

Martyn Whittock, A Brief History of Life in the Middle Ages: Scenes from the Town and Countryside of Medieval England (London: Robinson, 2009), 209.

69

Rawcliffe, Leprosy, 57.

70

Ibid., 59.

71

Ibid., 137.

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